Most ICU survivors were fit to drive at three months, but fewer than half had started

Design

Prospective observational cohort

Population

33 UK adults after ≥72 hours of mechanical ventilation or ECMO

Primary outcome

Driving ability on formal assessment about 12 weeks after discharge

Effect

79% fit to drive; 45% had resumed; 91% driving by 12 months

A UK cohort recruited 40 adults from six hospitals who had needed at least 72 hours of mechanical ventilation or ECMO. Thirty-three completed a licensing-agency-approved driving assessment at a median of 12.5 weeks after discharge, combining physical and cognitive testing, a simulator, track driving and an on-road test.

79% were judged capable of driving a standard vehicle, but only 45% had resumed. Seven were judged unfit, mostly for physical reasons, with fewer for psychological or cognitive ones; four of them were driving within a year after adaptations, retraining or lessons. By 12 months, 91% reported driving. Confidence rose after assessment, and 97% rated it very good or excellent.

Driving matters for independence, work and getting to follow-up, yet it is rarely discussed at discharge from intensive care. The cohort is small and from one assessment centre, but the gap between ability and resumption is striking.

Where formal driving assessment services are not available, as in much of India, a structured conversation about physical strength, cognition, mood and medication at follow-up is a practical start.

• Ask about driving at ICU follow-up or discharge; many survivors are fit but have not tried
• Check strength, cognition, vision, mood and sedating medicines before advising on driving
• Refer for formal assessment or retraining where doubt exists and services are available
• Advise patients of any legal duty to inform the licensing authority after serious illness
• Reassure that most survivors in this cohort were driving within a year

Why it matters

A simple conversation could return independence months earlier for many ICU survivors.

Don't overread it

This small single-centre cohort cannot set a safe time to resume driving for every survivor.

The statistics, in plain English

With 33 people assessed, each person is about 3 percentage points, so the proportions are rough. The cohort may also have included people more motivated to drive than ICU survivors in general.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.